Abstract
Hearing loss is the most common congenital birth defect. In 2007, American Academy
of Pediatrics updated the hearing screen guidelines to recommend hearing screen by
1 month of age, diagnostic evaluation by 3 months, and early interventions by 6 months.
Early interventions have been shown to improve developmental outcome in children with
hearing loss. Infants admitted to the neonatal intensive care unit (NICU) are at higher
risk for hearing loss. For infants born before 34 weeks' gestation, there are no guidelines
for initial hearing screen. Although auditory brain stem response can be reliably
performed at 32 to 34 weeks, in most NICUs, they are screened prior to discharge per
universal hearing screen guidelines. In high-risk infants, often with prolonged hospitalization,
this leads to missed opportunity for early detection and implementation of early intervention
services. Using quality improvement methodology, an updated hearing screen algorithm
was developed and implemented in our level IV NICU along with an electronic medical
record tool to improve the process of identifying infants meeting criteria for hearing
screen.
Keywords
hearing screen - quality improvement - neonatal intensive care unit - hearing loss
